MEMBERSHIP FORM
Please print out, complete and send with a stamped self-addressed envelope and payment made out to 'Southern Early Music Forum' to :
Alan Lane, SEMF Membership Secretary, 'Russetts', Whitemans Green, Cuckfield, West Sussex RH17 5DB
| NAME | ............................................................ |
| TITLE | .................................... |
| ADDRESS | ............................................................ |
| ............................................................ | |
| ............................................................ | |
| ............................................................ | |
| ............................................................ | |
| POSTCODE | ................. |
| TELEPHONE | .................................... |
| FAX | .................................... |
| .................................................. | |
| INTERESTS | .................................................. |
| INTERESTS | .................................................. |
| INTERESTS | .................................................. |
| INTERESTS | .................................................. |
This information will be held on computer registered under the Data Protection Act and will be used to send you information about SEMF activities.
Do you want your details to appear in our printed membership lists? YES / NO
2009/2010 MEMBERSHIP FEES
Full Membership £9.50 Family Membership £5.00 Student Membership £5.00 Library Membership £5.00 Over-65 Membership £8.00
- Discount
- for new members or
for payment before 1 March£1.00
I enclose £.............. and apply for membership of Southern Early Music Forum for the membership year ending at the end of February 2010.
Please sign and date below.
signed:...................................... dated: ......................